Evaluation of Safety and Efficacy of Bixdo Ultra Compact Water Flosser

Exclusion Criteria

• •1. Systemic disease self-reported that has an impact on periodontal status (e.g., diabetes mellitus, HIV/AIDS, rheumatoid arthritis).
• •2. History of any autoimmune disease (e.g., pSS, SLE, psoriasis, IBS).
• •3. History of immunosuppressive chemotherapy or history of any disease known to severely compromise immune function (e.g., cytomegalovirus infection) within the last 5 years.
• •4. Any acute intraoral infection (e.g., herpetic gingivostomatitis, herpangina, abscesses).
• •5. Patients with visible carious lesions, periodontitis, orthodontic appliances, or removable partial dentures.
• •6. Patients with mild plaque-induced gingivitis: \< 50% BOP, \<1.75 modified gingival index (MGI), and \<0.60 Rustogi Modification of the Navy Plaque Index (RMNPI) and PPD ≤5 mm.
• •7. Patients with PPD \>5 mm.
• •8. Need for antibiotic premedication for routine dental procedures.
• •9. Use of antibiotics within the last 3 months.
• •10. Daily use of steroids or non-steroid anti-inflammatory therapy within the last 3-months.
• •11. Patients who self-report pregnancy or lactation (hormonal changes that can affect periodontal health and aggravate existing periodontal disease).
• •12. Current smokers.
• •13. Inability or unwillingness to sign informed consent form.
• •14. Patients who do not agree to delay dental prophylaxis, elective dental treatment, and cosmetic procedures (i.e. tooth whitening, crowns).
• •15. For the main study only: Patients who do not agree to refrain from using any non-study dental device or oral care products, return for scheduled visits, and comply with all study procedures.
• •16. Anything that would place the individual at increased risk or preclude the individual's full compliance with or completion of the study at the discretion of the investigators.
• •17. For the main study only: Patients who need assistance from others to perform their daily oral hygiene practices or read the manual of instructions that come with the at-home product.
• •18. Those not fluent in English